Medische beeldvorming en stralingstherapie: recente ontwikkelingen en toekomstverwachtingen geillustreerd aan de hand van voorbeelden uit de kankerbestrijding
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Medische beeldvorming en stralingstherapie: recente ontwikkelingen en toekomstverwachtingen geillustreerd aan de hand van voorbeelden uit de kankerbestrijdingTranslated Title
Medical imaging and radiation therapy: recent developments and expectations illustrated with cancer casesPubliekssamenvatting
De stand van zaken en toekomstige ontwikkelingen op het gebied van de toepassing van straling voor het diagnosticeren en behandelen van enkele frequent voorkomende vormen van kanker worden in dit rapport behandeld. Het is onderdeel van de Volksgezondheid Toekomst Verkenning 2002 van het Rijksinstituut voor Volksgezondheid en Milieu. Een scala aan moderne diagnostische beeldvormende technieken zoals dynamische MRI en computer tomografie maken zowel het identificeren en behandelen van tumoren als het evalueren van het behandelresultaat eenvoudiger. Drijvende kracht achter vele verbeteringen zijn de ontwikkelingen in de micro-elektronica en in de informatie- en communicatietechnologie. Informatie over de structuur van een aandoening wordt steeds vaker aangevuld met beelden die functionele aspecten belichten. Echter, eenvoudige technieken voor de vroegtijdige opsporing van tal van vormen van kanker zijn nog niet beschikbaar. Radiotherapie blijft, ook dit decennium, de belangrijkste op straling gebaseerde vorm van behandeling van kanker. Door optimaal inzetten van de nu reeds bekende inzichten op dit gebied is nog de nodige gezondheidswinst te boeken. De toekomst van bijvoorbeeld radio-immunotherapie en fotodynamische therapie blijft voorlopig onzeker. Het steeds vaker uitvoeren van kosten-baten analyses moet de kans op introductie van ineffectieve nieuwe diagnostische technieken verkleinen, ook bij de kankerbestrijding. Daarnaast zal de groeiende aandacht voor het bepalen van de kwalititeit van leven resulteren in een verbeterde evaluatie van behandelopties.Discussed here is the state of the art and future developments of radiation application for diagnosing and treating several frequently occurring cancers. This report constitutes part of the Public Health Status and Forecast 2002, produced by the National Institute for Public Health and the Environment in the Netherlands. A variety of modern diagnostic imaging techniques such as dynamic MRI and computed tomography actually facilitate identification and treatment of tumours, along with the follow-up after treatment. The driving force behind this flourishing development is formed by the advancements in microelectronics and ICT. Information on the morphology of these disorders is being increasingly supplemented with visualized functional aspects. For most tumours simple screening techniques are, however, lacking. The dominant radiation-based cancer-treatment modality for this decade is still radiotherapy. Full exploitation of current radiotherapeutic know-how may clearly enhance cure rates. The future of such treatment modalities as radioimmunotherapy and photodynamic therapy remains uncertain. Increased implementation of cost-effectiveness analyses must reduce the risk of introducing ineffective new diagnostic techniques and treating cancer. Growing interest in quality-of-life assessments will improve the evaluation of alternative treatment modalities.
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